"Keyhole" Surgery Can Stop Indigestion.

For 40 years, Dallas (-I-ex.) physician David Brand felt the burn. The chronic and severe heartburn finally stopped after treatment with "keyhole" surgery. He had a hiatal hernia and a weakened lower esophageal sphincter. A normal sphincter opens to let food into the stomach and closes to prevent regurgitation of gastric acid and undigested food. For years, he took the most effective antacid medications available, modified his diet, and lost weight--all to no avail.

Daniel B. Jones, assistant professor of surgery, The University of Texas Southwestern Medical Center at Dallas, solved Brand's problem. He performed laparoscopic surgery in which the upper part of the stomach, called the fundus, partially is wrapped around the lower esophagus. The procedure is known as the Toupet Fundoplication.

The Toupet wrap is an improved version of an existing procedure that has been used to treat gastroesophageal reflux disease (GERD). It is major surgery done through five small incisions that measure 10 millimeters each. That's why it is called "keyhole" surgery. A small 10-millimeter telescope is inserted into the abdominal cavity, and the image is projected on a television monitor.

The Toupet wrap uses the muscle of the fundus to bolster the weakened spontaneous movement of the lower esophagus...